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claim for

Housing Benefit

and Council Tax

Support

Ref No:
Please fill in this form in CAPITAL LETTERS and black ink and return it to: Benefits
Service, Enfield Council, PO Box 63, Silver Street, Enfield, EN1 3XW

Note: You should continue to pay your Council Tax until your benefit is worked out.

Are you: An Owner Occupier?
A Private Tenant
Housed in Enfield by
another Borough

If yes, which Borough?

Do you or your partner receive Income
Support/Jobseekers Allowance (income Yes
based)/Employment and Support
Allowance (income related)
Are you or your partner waiting to hear about
a claim for Income Support/Jobseekers Yes
Allowance (income based)/Employment and
Support Allowance (income related)

FOR OFFICE USE ONLY

UD/PTD 07 nA i ^ nA *
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